Majority of patients affected by Pilonidal Sinus disease come with the complaints of pain, swelling, pus discharge and difficulty in sitting around the tail bone area. Few patients complain that after discharge of pus they feel better for few days to months and again same problem happens to them. Most of the patients are in the age group of twenty to thirty years. It is common in males and mostly affects hairy males.

Pilonidal = pilus i.e. hair, nidus i.e. nest and Sinus = a tract which is blind at one end.

• Mechanical factor theory- due to vibration and friction shedding of the hair occurs. Thus it enters in the gluteal cleft and into the opening of the sweat glands.

Features

• Pain & swelling around the tail bone area.

• Pus or bloody discharge around tailbone area

• Unexpected moisture in the tailbone area

• Discomfort with sitting on the tailbone.

Diagnosis of Pilonidal Sinus

• History of the patient.

• Examination of the patient.

• Probing of the sinus tract under local anaesthesia

• Sinogram of the tract

• MRI

Risk Factors

• Obesity.

• Family history.

• Prolonged sitting.

• Greater amount of hair.

• Not enough exercise

Management

• Conservative treatment has minimal role in curing the disease .

• Keeping in mind the recurrence of disease, we prefer to manage it with kshar sutra therapy which is done under local anaesthesia. After application of kshar sutra, patient is advised for change of sutra after every seven to ten days till patient gets recovered.